• 제목/요약/키워드: Soft-tissue response

검색결과 101건 처리시간 0.025초

비스포스포네이트 연관 악골괴사의 치료 방식과 투약 휴지기가 치료 예후에 미치는 영향 (The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient)

  • 이승현;박군효;이재열;김용덕;신상훈;정인교;김규천;김욱규
    • 대한치과의사협회지
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    • 제53권2호
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    • pp.120-131
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    • 2015
  • Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

초기 골 접촉이 없는 수산화 인회석 피복 임프란트 주위 골의 치유 (Healing of the Bone around Hydroxyapatite-Coated Implants without Primary Bone Contact)

  • 조형수;신광용;김흥중;박주철;한경윤;김병옥
    • Journal of Periodontal and Implant Science
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    • 제29권2호
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    • pp.415-433
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    • 1999
  • Implant stability is the key to long-term successful outcome for osseointegrated implants. To evaluate the initial healing response of bone around HA-coated implants without primary bone contact. 21 HA-coated thread type implants(STERI-OSS?) were placed in the femurs of 5 mongrel dogs, about 1-year old. Implants, 8 mm in length and 3.8mm(experimental 1group), 5.0mm(experimental 2group) and 6.0mm(control group) in diameter, were inserted after 3 holes of 6.0mm in diameter and 10mm in depth were prepared in the surgical sites each dog. Implants were supported by only nonresorbable membrane($Teflon^{(R)}$), in order to prevent the ingrowth of upper soft tissue into the gap between bone and implant, and to maintain each implant to be positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 implants were inserted in 2 dogs for mobility test and removal torque test. Fluorescent dyes were injected for the observation of new bone formation in order of $Terramycin^{(R)}$, Arizarin $Red^{(R)}$, and $Calcein^{(R)}$ at an interval of 2 weeks. 3 dogs were sacrificed for histologic observation at 4, 8, and 12-week after placement. Light microscopy and confocal laser scanning microscopy were used to qualitatively characterize the bone around HA-coated implant. 2 dogs were sacrificed for mobility test($Periotest^{(R)}$, Simens AG, Bensheim, Germany) and removal torque test($Autograph^{(R)}$ AGS-1000D series, Japan) at 8 and 12-week after placement The results were as follows: 1. Histologic observation showed that osseointegration occurred to both control and experimental groups as time lapse, but delayed bone healing was revealed in 3.8mm group (experimental 1group), compared to contrtol group and 5.0mm group (experimental 2group). 2. The mobility test showed that the experimental groups had no distinguishable movement during experimental periods of 8 and 12-week, and there was no difference in mobility depending on the gap between bone and implant, and time lapse. 3. The removal torque forces were increased depended on the gaps decreasing between bone and implant, and time lapse. The results suggest that HA-coated implant without primary bone contact, based on guided bone regeneration could obtain its stability in all experimental groups as time lapse, but bone healing was delayed in experimental group of 3.8mm. And the results suggested that studies on correlationship between mobility test and removal torque test for implant stability would be necessary.

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두릅(Aralia elata)의 체세포배 유도, 발아 및 식물체 재분화에 미치는 요인 (Factors Influencing Somatic Embryo Induction and Plant Regeneration in Aralia elata Seem.)

  • 문흥규;오경은;손성호
    • 식물조직배양학회지
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    • 제26권4호
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    • pp.275-280
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    • 1999
  • 두릅나무 (Aralia elata Seem.) 2년 생 11개체의 동아를 1.0 mg/L 2,4-D, 3% sucrose, 0.3% gelrite를 포함한 MS 고체 배지에서 체세포배 형성, 발아 및 식물체 재분화에 미치는 개체목의 효과를 조사하였다. 배발생 캘러스의 유도는 개체목에 따른 차이가 있었으나 발아 및 식물체 재분화는 차이가 뚜렷하지 않았다. 배발생 캘러스는 대체로 노란색을 띠었고, 조성은 비배발생 캘러스보다 부드럽고 생장은 다소 느렸다. 체세포배의 발아 및 식물체 재분화는 MS배지의 염류 농도가 크게 영향하였고, 기본배지보다는 염류 농도를 반감시킨 1/2 MS배지에서 BA및 ABA의 처리에 관계없이 양호한 배발아 및 식물체 재분화를 나타냈다. BA처리는 0.1mg/L 농도에서 배축과 자엽 발달에 다소 촉진효과를 나타냈으나 발아와 재분화율은 기본배지보다 우수하지 못했다. 발아되는 배는 자엽수 및 형태에 있어 다양한 변이를 나타냈다. ABA처리는 두릅 체세포배의 발아 및 재분화에 비효과적이었다. 재분화된 식물체는 인공배양토에서 95%이상 환경순화되어 포지에 이식 후 형태적 변이 없이 정상생장이 가능하였다.

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설하신경마비를 동반한 설골골절: 증례보고 (Hyoid Bone Fracture Associated with Hypoglossal Nerve Palsy: A Case Report)

  • 김신락;박진형;한예식
    • Archives of Plastic Surgery
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    • 제38권2호
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    • pp.199-202
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    • 2011
  • Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

Morphological and Genetic Characteristics of Colletotrichum gloeosporioides Isolated from Newly Emerging Static-Symptom Anthracnose in Apple

  • Jeon, Yongho;Cheon, Wonsu
    • 한국균학회소식:학술대회논문집
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    • 한국균학회 2014년도 추계학술대회 및 정기총회
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    • pp.34-34
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    • 2014
  • Filamentous fungi of the genus Colletotrichum (teleomorph, Glomerella) are considered major plant pathogens worldwide. Cereals, legumes, vegetables, and fruit trees may be seriously affected by this pathogen (1). Colletotrichum species cause typical disease symptoms known as anthracnoses, characterized by sunken necrotic tissue, where orange conidial masses are produced. Anthracnose appears in both developing and mature plant tissues (2). We investigated disease occurrence in apple orchards from 2013 to 2014 in northern Gyeongbuk province, Korea. Typical anthracnose with advanced symptoms was observed in all apple orchards studied. Of late, static fruit spot symptoms are being observed in apple orchards. A small lesion, which does not expand further and remains static until the harvesting season, is observed at the beginning of fruit growth period. In our study, static symptoms, together with the typical symptoms, were observed on apples. The isolated fungus was tested for pathogenicity on cv. 'Fuji apple' (fully ripe fruits, unripe fruits, and cross-section of fruits) by inoculating the fruits with a conidial suspension ($10^5$ conidia/ml). In apple inoculated with typical anthracnose fungus, the anthracnose symptoms progressed, and dark lesions with salmon-colored masses of conidia were observed on fruit, which were also soft and sunken. However, in apple inoculated with fungi causing static symptoms, the size of the spots did not increase. Interestingly, the shape and size of the conidia and the shape of the appressoria of both types of fungi were found to be similar. The conidia of the two types of fungi were straight and cylindrical, with an obtuse apex. The culture and morphological characteristics of the conidia were similar to those of C. gloeosporioides (5). The conidia of C. gloeosporioides germinate and form appressoria in response to chemical signals such as host surface wax and the fruitripening hormone ethylene (3). In this study, the spores started to germinate 4 h after incubation with an ethephon suspension. Then, the germ tubes began to swell, and subsequently, differentiation into appressoria with dark thick walls was completed by 8 h. In advanced symptoms, fungal spores of virtually all the appressoria formed primary hyphae within 16 h. However, in the static-symptom fungus spores, no primary hyphae formed by 16 h. The two types of isolates exhibited different growth rates on medium containing apple pectin, Na polypectate, or glucose as the sole carbon. Static-symptom fungi had a >10% reduction in growth (apple pectin, 14.9%; Na polypectate, 27.7%; glucose, 10.4%). The fungal isolates were also genetically characterized by sequencing. ITS regions of rDNA, chitin synthase 1 (CHS1), actin (ACT), and ${\beta}$-tubulin (${\beta}t$) were amplified from isolates using primer pairs ITS 1 and ITS 4 (4), CHS-79F and CHS-354R, ACT-512F and ACT-783R, and T1 and ${\beta}t2$ (5), respectively. The resulting sequences showed 100% identity with sequences of C. gloeosporioides at KC493156, and the sequence of the ${\beta}$t gene showed 100% identity with C. gloeosporioides at JX009557.1. Therefore, sequence data from the four loci studied proves that the isolated pathogen is C. gloeosporioides. We also performed random amplified polymorphic DNA-PCR, which showed clearly differentiated subgroups of C. gloeosporioides genotypes. The clustering of these groups was highly related to the symptom types of the individual strains.

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나노구조 표면에 관한 문헌고찰 (A Literature Review on Nano-Modified Implant Surfaces)

  • 박고운;차민상;김대곤;박찬진;조리라
    • 구강회복응용과학지
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    • 제29권2호
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    • pp.141-151
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    • 2013
  • 티타늄 산화막을 나노단위에서 변형시키는 방법은 다공성 표면을 강화하는 내부적 접근과 나노입자를 피복하는 외부적 접근으로 나눌 수 있다. 나노표면은 나노튜브, 나노피트, 나노노듈 및 다형구조 등 다양한 형태를 지닌다. 형성방법 및 형성재료에 따라 다른 표면이 생성되지만, 현재까지 표준화된 형성방법은 없다. 나노표면을 분석해 보면 마이크론 단위의 표면구조에는 영향을 미치지 않으며 전기화학적으로 안정적이다. 나노표면은 세포독성이 거의 없으며 조골세포의 증식과 분화를 모두 촉진하고, 섬유모세포의 증식을 저해하여 연조직 개재를 감소시키는 효과를 가진다. 또한 세포 및 단백질과 유사한 크기 및 형태를 가지기 때문에 조직과의 친화성이 우수하여 골유착을 증진시킨다. 하지만 그 작용이 미치는 범위는 극히 제한되어 있기 때문에 골조직과의 거리가 있는 경우에는 효과가 미미하다. 마이크론 단위의 표면과는 달리 나노표면은 광촉매효과로 인한 항균작용을 가지지만 지속시간이 짧아 실제 임상에서의 적용효과는 의문시 된다. 하지만 마이크론 단위의 표면거칠기가 가지는 단점을 배제할 수 있어 다양한 가능성을 가지기 때문에 더 많은 연구가 필요하다.

Triamcinolone Acetonide 주사를 이용한 족관절 외과 점액낭염의 치료 (Triamcinolone Acetonide Injections for Lateral Malleolar Bursitis of the Ankle)

  • 우승훈;김정신;손승민;신원철
    • 대한족부족관절학회지
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    • 제23권1호
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    • pp.12-17
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    • 2019
  • Purpose: This study examined the clinical outcomes and usefulness of triamcinolone acetonide (TA) injections as an option in the conservative treatment of patients with lateral malleolar bursitis of the ankle. Materials and Methods: A total of 27 patients (27 ankles), in whom TA injection had been performed between March 2016 and June 2017, were reviewed retrospectively. After the aspiration of fluid in the lateral malleolar bursal sac, 1 mL (40 mg) of TA was injected into the malleolar bursal sac. After the injection, the ankle was compressed with an elastic cohesive bandage for 2 to 4 weeks. The clinical outcomes and side effects were evaluated at the following time points: 2 weeks, 4 weeks, 3 months, 6 months, and 1 year after TA injection therapy. The responses to treatment were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. Results: The mean age was 62.1 years (range, 41~81 years); there were 19 males and 8 females. Complete resolution was observed in 26 patients (96.3%) after the first or second application of a TA injection, and a partial response was observed in 1 patient (3.7%) after the first TA injection. The physical component scores of Medical Outcomes Study 36-item Short-Form Health Survey improved from 71.1 to 76.0 at the last follow-up (p=0.001). Associated complications were 1 patient (3.7%) with skin atrophy and 3 patients (11.1%) with transient hyperglycemia in diabetes mellitus. Conclusion: TA injection is a useful and safe procedure for patients not responding to the usual conservative treatment of lateral malleolar bursitis of the ankle.

파월국군장병의 고엽제 위해에 관한 예비적 역학조사 (A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War)

  • 김정순;임현술;이홍복;이원영;박영주;김성수
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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대세포 폐암의 임상적 양상과 생존률에 대한 분석 (Large Cell Carcinoma of the Lung - An analysis of clinical features and survival)

  • 양진영;이형식;문성록;김귀언;서창옥;노준규;오원용;황인순
    • Radiation Oncology Journal
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    • 제8권2호
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    • pp.219-223
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    • 1990
  • 1985년 1월부터 1989년 12월까지 연세대학교 의과대학 치료방사선과 및 연세암센터에서 치료받은 33명의 대세포 폐암 환자에 대한 후향적 분석을 시행하였다. 이중 28명 이 남자로 대부분을 차지했으며 평균 연령은 59세였다. 대세포 미분화폐암이 가장 많았으며 종양의 위치는 우측 폐에 19명, 좌측 폐에 14명에서 발견되었다. 일반적으로 대세포 폐암은 상당수가 폐의 주변부에 종양이 위치해 있는 것으로 알려져 있지만 본 조사에서는 중심부에 위치해 있는 경우가 주변부 만큼 많이 관찰되었다($51.5\%$$48.5\%$). 33명의 환자중 21명이 IIIB기 이상의 상당히 진행된 병변을 갖고 진단되어 졌다. 총 15명의 환자에서 원격전이가 관찰되었는데 이중 11명이 진단당시부터 원격전이를 갖고 있었고 나머지 4명은 치료 도중이나 치료 후 발견된 경우였다. 원격전이 부위는 다양하였는데, 연부조직, 피부, 췌장 및 충수돌기등 다른 폐암에서는 흔치 않는 부위에서의 원격전이가 관찰되었다. 치료는 개인별로 차이가 많았는데, 초기에 진행된 병변을 가진 환자가 많았으므로 19명 만이 근치적 목적의 치료를 받았으며 나머지 14명은 고식적인 방법으로 치료를 받았는데 치료후 2명의 환자에서 완전 관해를 얻었다. 4명의 환자가 24개월에서 54개월까지 장기 생존하였으며 2년 생존율은 $14.3\%$였고 중앙생존 기간은 6개월 이었다. 생존율에 영향을 주는 인자들을 분석해 본 결과 늑막 유출액이 없었던 환자군과 치료후 완전 관해를 보였던 환자군에서 통계학적으로 유의하게 생존율이 좋았다 (p<0.01).서만이 방사선 치료에 의해 완전관해를 얻을 수 있었던바($25\%$) (p<0.001), 모두 통계적으로 유의한 차이를 보였다. 한편 이를 원발부위, T-병기 그리고 N-병기에 따라 분석해본 결과, 특히 T-병기중 T3, 4에서는 유의한 차이가 관찰되었으나(p<0.0005), T1, 2에서는 유의한 차이가 관찰 되지 않았다(0.3, 수술이 필요하였던 환자는 $1\%$로 합병증의 증가 없이 A점에 8900cGy, 직장에 7300cGy정도의 국소치료가 가능함을 보여 주었으나 생존율에 대한 추후 분석이 따라야 할 것으로 사료된다.보면 6,000rad이하에서 20/63$(34.9\%)$의 실패율에 비하여 6,000rad이상일 때는 10/49$(20.4\%)$의 실패율이었다. 연령 벨로는 $40\~49$세에서 실패율(14/41 $24.1\%$)이 많았다. 본 성적으로 보아서 생존율은 여러 저자들과 큰 차이가 없음을 알 수 있었고 A점 선량은 8,000rad 이상, B점은 6,000rad이상이 조사되어야 적정선량이 됨을 시사해 주고 있다.\%$가 대부분이

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in Vitro와 ex vivo에서 황백 온수추출물의 신생혈관 억제효과 (The Anti-angiogenic Potential of a Phellodendron amurense Hot Water Extract in Vitro and ex Vivo)

  • 김억천;김서호;배기호;김한성;겔린스키 미첼;김택중
    • 생명과학회지
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    • 제25권6호
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    • pp.693-702
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    • 2015
  • 신생혈관형성을 억제하는 것은 최근들어 많은 고형암의 치료에 있어서 매우 유용한 접근 방법이다. 현재까지 가장 잘 알려진 접근 방법은 신생혈관형성의 핵심인자인 혈관내피세포성장인자(VEGF)를 표적으로 하는 방법이다. 다양한 화학예방 물질들을 포함하는 많은 자연의 생산물들이나 추출물들은 그들의 항신생혈관형성 성질을 통하여 악성종양의 성장을 억제하고 있다. 황백은 항종양, 항균, 항염증 및 그외 다른 생물학적 작용을 가지고 있는, 오래전부터 널리 사용되어온 한국 전통 약재이다. 우리는 종양의 성장, 침투, 전이에 있어서 매우 중요한 과정인 신생혈관형성에 미치는 황백 온수추출물의 효과를 연구하였다. 황백 온수추출물의 항신생혈관형성 효과를 확인하기 위해서 혈관 내피세포의 성장, 이동, 침투, 관형성 그리고, 자이모그램 분석을 수행하였으며, 흰쥐 대동맥 주변 미세혈관 발아실험을 진행하였다. 그 결과, 황백 온수추출물은 혈관내피세포성장인자(VEGF)에 의해 유도되는 혈관내피세포의 성장, 이동, 침투, 관형성 그리고, 대동맥의 혈관발아를 억제하는 효과를 in vitro와 ex vivo 실험을 통해서 확인하였다. 또한, 황백 추출물은 VEGF에 의해 유도되는 기질금속단백질분해효소 (MMP)-2와 -9의 활성화를 저해하였다. 본 연구 결과들은 황백 온수추출물의 신생혈관형성 억제작용이 암과 같은 혈관신생과 관련된 질병을 치료하는데 좋은 소재가 될 수 있음을 시사한다